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Another View: NH has mental health treatment plan; if only it would fund it

BY PETER JANELLE and TIMOTHY SOUCY

Since the Sandy Hook Elementary School tragedy in December, there has been a national discussion about our failing mental health system and how adults and children with behavioral health issues in our country are treated. The President's recently announced plan for addressing the Connecticut shootings would increase access to mental health services; but it also would add controls on some types of guns, so we can expect an emotional, expensive and difficult debate in Congress.

It also is time for a more public discussion about New Hampshire's community mental health system, once a model for other states, which has been all but decimated by years of state budget cuts. The effects of this neglect can be found in the wait times for outpatient community mental health services, the extended stays that adults and children are experiencing in hospital emergency rooms, the frequent closure of admissions at the New Hampshire Hospital, the loss of beds due to inadequate reimbursement of residential facilities, the lack of designated receiving facilities for those in a mental health crisis, and the human tragedies that are happening every day in our state.

On Jan. 14, a month before Gov. Maggie Hassan will present her budget to the Legislature, the NH Community Behavioral Health Association released an outline for restoring the system, based on the state's 2008 Ten-Year Mental Health Plan. As leaders in the mental health field in New Hampshire, we believe it is our responsibility to present a proposal for addressing the crisis now, before the community-based system falls into further collapse.

The plan was released almost five years ago after extended study and evaluation by a broad group of stakeholders, including our association, the Department of Health and Human Services, New Hampshire Hospital and others. It was hailed as a great step forward for both the state and the community-based system. But while some small efforts have been made to begin the investments outlined in the plan, the reality is that since 2008 we have actually fallen backward at almost every level.

The NHCBHA strongly believes that the governor and the Legislature must take the appropriate steps to correct this situation now by funding recommendations made in the plan to the levels recommended for the 2014-2015 state fiscal year. Further, NHCBHA believes that measures for funding children's mental health and substance abuse programs also need to be addressed and funded in this year's state budget.

But as we have discussed the urgency of funding the ten-year plan over the past few weeks with policymakers in Concord, there has been some push back from those working to craft a state budget. There is a reluctance to promise too much, too soon in any area of the budget. There is an equally strong reluctance to promise restoration of state programs that were cut or eliminated two years ago. The official mantra is: "Be innovative and be fiscally responsible."

The public and our elected representatives need to be mindful of the fact that the lack of investment in community mental health services is driving costs in other areas of state, county and local government. Taxpayers' money is already being spent, but in the wrong places and with fewer timely, effective and humane results than if it was being directed appropriately. Money is being consumed in a fragmented "system" that has grown up in place of a community-based one that actually worked once, and which can work again.

The Ten-Year Mental Health Plan still provides a solid framework for restoring our community-based mental health system, and its recommendations should be funded now. The areas of state investment that NHCBHA believes should stand as the baseline for adequate public health, safety and humanity include: increasing community residential supports and community-based inpatient psychiatric care, developing assertive community treatment (ACT) teams, retaining and developing our community mental health workforce, and working closely with the Department of Corrections on mental health housing, training and specialized services.

In 2008, this list of investments was seen as reasonable and necessary; five years later, it still is. The current default model for providing mental health services is the opposite of innovation and fiscal responsibility, and it benefits no one: not taxpayers, citizens, communities or the adults and children who need and deserve these critical services the most. It's time for our state leaders to act in a truly fiscally responsible manner and fund the Ten-Year Mental Health Plan.

Peter Janelle is president and CEO, and Timothy Soucy is chairman of the board, of The Mental Health Center of Greater Manchester.